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<ep-patent-document id="EP03810553B1" file="EP03810553NWB1.xml" lang="en" country="EP" doc-number="1562525" kind="B1" date-publ="20161221" status="n" dtd-version="ep-patent-document-v1-5">
<SDOBI lang="en"><B000><eptags><B001EP>ATBECHDEDKESFRGBGRITLILUNLSEMCPTIESI....FIRO..CY..TRBGCZEEHU..SK....................................</B001EP><B003EP>*</B003EP><B005EP>J</B005EP><B007EP>JDIM360 Ver 1.28 (29 Oct 2014) -  2100000/0</B007EP></eptags></B000><B100><B110>1562525</B110><B120><B121>EUROPEAN PATENT SPECIFICATION</B121></B120><B130>B1</B130><B140><date>20161221</date></B140><B190>EP</B190></B100><B200><B210>03810553.2</B210><B220><date>20031031</date></B220><B240><B241><date>20050504</date></B241><B242><date>20110531</date></B242></B240><B250>en</B250><B251EP>en</B251EP><B260>en</B260></B200><B300><B310>0213833</B310><B320><date>20021105</date></B320><B330><ctry>FR</ctry></B330></B300><B400><B405><date>20161221</date><bnum>201651</bnum></B405><B430><date>20050817</date><bnum>200533</bnum></B430><B450><date>20161221</date><bnum>201651</bnum></B450><B452EP><date>20160715</date></B452EP></B400><B500><B510EP><classification-ipcr sequence="1"><text>A61F   2/44        20060101AFI20160620BHEP        </text></classification-ipcr><classification-ipcr sequence="2"><text>A61F   2/30        20060101ALI20160620BHEP        </text></classification-ipcr><classification-ipcr sequence="3"><text>A61B  17/064       20060101ALI20160620BHEP        </text></classification-ipcr><classification-ipcr sequence="4"><text>A61F   2/00        20060101ALI20160620BHEP        </text></classification-ipcr><classification-ipcr sequence="5"><text>A61F   2/08        20060101ALI20160620BHEP        </text></classification-ipcr></B510EP><B540><B541>de</B541><B542>BANDSCHEIBENPROTHESE</B542><B541>en</B541><B542>INTERVERTEBRAL DISK PROSTHESIS</B542><B541>fr</B541><B542>PROTHESE DE DISQUE INTERVERTEBRAL</B542></B540><B560><B561><text>EP-A- 0 560 141</text></B561><B561><text>WO-A-00/74606</text></B561><B561><text>WO-A-01/01893</text></B561><B561><text>US-B1- 6 368 350</text></B561></B560></B500><B600><B620EP><parent><cdoc><dnum><anum>10185004.8</anum><pnum>2327375</pnum></dnum><date>20100930</date></cdoc><cdoc><dnum><anum>13170071.8</anum><pnum>2633835</pnum></dnum><date>20130531</date></cdoc></parent></B620EP></B600><B700><B720><B721><snm>BEAURIN, Jacques</snm><adr><str>Impasse du Milleraie</str><city>21910 Saulon La Chapelle</city><ctry>FR</ctry></adr></B721><B721><snm>FUENTES, Jean-Marc</snm><adr><str>Le Piquet,Allée des Mésanges</str><city>34790 Grabels</city><ctry>FR</ctry></adr></B721><B721><snm>VITAL, Jean-Marc</snm><adr><str>Ctr. Hospitalier Pellegrin,
Place Amélie Raba Léon</str><city>33076 Bordeaux Cedex</city><ctry>FR</ctry></adr></B721><B721><snm>DUFOUR, Thierry</snm><adr><str>22, rue des Ormes</str><city>45160 Olivet</city><ctry>FR</ctry></adr></B721><B721><snm>HUPPERT, Jean</snm><adr><str>16, allée Chataignière</str><city>42580 L'Etrat</city><ctry>FR</ctry></adr></B721></B720><B730><B731><snm>LDR Medical</snm><iid>100164445</iid><irf>LDR/10/PCT</irf><adr><str>4, rue Marie Curie</str><city>10430 Rosières près Troyes</city><ctry>FR</ctry></adr></B731></B730><B740><B741><snm>Debay, Yves</snm><iid>100023671</iid><adr><str>Cabinet Debay 
126 Elysée 2</str><city>78170 La Celle Saint Cloud</city><ctry>FR</ctry></adr></B741></B740></B700><B800><B840><ctry>AT</ctry><ctry>BE</ctry><ctry>BG</ctry><ctry>CH</ctry><ctry>CY</ctry><ctry>CZ</ctry><ctry>DE</ctry><ctry>DK</ctry><ctry>EE</ctry><ctry>ES</ctry><ctry>FI</ctry><ctry>FR</ctry><ctry>GB</ctry><ctry>GR</ctry><ctry>HU</ctry><ctry>IE</ctry><ctry>IT</ctry><ctry>LI</ctry><ctry>LU</ctry><ctry>MC</ctry><ctry>NL</ctry><ctry>PT</ctry><ctry>RO</ctry><ctry>SE</ctry><ctry>SI</ctry><ctry>SK</ctry><ctry>TR</ctry></B840><B860><B861><dnum><anum>IB2003004872</anum></dnum><date>20031031</date></B861><B862>en</B862></B860><B870><B871><dnum><pnum>WO2004041129</pnum></dnum><date>20040521</date><bnum>200421</bnum></B871></B870><B880><date>20050817</date><bnum>200533</bnum></B880></B800></SDOBI>
<description id="desc" lang="en"><!-- EPO <DP n="1"> -->
<p id="p0001" num="0001">The present invention relates to an intervertebral disk prosthesis, intended to substitute the fibrocartilaginous disks joining the vertebrae in the spinal column, particularly on the cervical spine.</p>
<p id="p0002" num="0002">Various types of prosthesis are known in the prior art. Some of these prostheses, either because they are made of compressible material or because they allow excessive movement of the different constituent parts of the prosthesis with respect to each other, may induce relatively easily the ejection of at least one part of the prosthesis outside the vertebrae, which is not desirable for the patient.</p>
<p id="p0003" num="0003"><patcit id="pcit0001" dnum="US6368350B1"><text>US 6,368,350 B1</text></patcit> discloses an intervertebral disc prosthesis according to the preamble of claim 1.</p>
<p id="p0004" num="0004">The purpose of the present invention is to remedy some drawbacks of the prior art by proposing a simple intervertebral disk prosthesis which makes it possible to limit the movements of the different constituent parts of the prosthesis with respect to each other.</p>
<p id="p0005" num="0005">This purpose is achieved by an intervertebral disk prosthesis as defined in claim 1. Further embodiments of the invention are defined in the dependent claims.<!-- EPO <DP n="2"> --></p>
<p id="p0006" num="0006">Other features and advantages of the present invention will be seen more clearly upon reading the description below, with reference to the appended figures, wherein:
<ul id="ul0001" list-style="dash" compact="compact">
<li><figref idref="f0001">figures 1</figref> a and 1 b respectively represent a bottom view and a perspective bottom view of the upper plate,</li>
<li><figref idref="f0001">figures 2a and 2b</figref> respectively represent a top view and a perspective top view of the lower plate,</li>
<li><figref idref="f0001">figures 3a and 3b</figref> respectively represent a top view and a perspective top view of the core,</li>
<li><figref idref="f0002">figures 4a and 4b</figref> respectively represent a perspective top view and a side view of the intervertebral disk prosthesis according to the embodiment of <figref idref="f0001">figures 1a, 1b, 2a, 2b, 3a and 3b</figref>,</li>
<li><figref idref="f0002">figures 5a and 5b</figref> respectively represent a side view and a sectional view along the plane D-D of <figref idref="f0002">figure 5a</figref> of the intervertebral disk prosthesis according to a second embodiment,<!-- EPO <DP n="3"> --></li>
<li><figref idref="f0003">figure 6a</figref> represents a side view of an intervertebral disk prosthesis ,</li>
<li><figref idref="f0003">figures 6b and 6d</figref> represent a sectional view along the plane A-A of <figref idref="f0003">figure 6a</figref>, the core having, respectively, a slight clearance and no clearance with respect to the lower plate,</li>
<li><figref idref="f0003">figures 6c and 6e</figref> represent a sectional view along the plane B-B of <figref idref="f0003">figure 6b and 6d</figref>, respectively, of the intervertebral disk prosthesis,</li>
<li><figref idref="f0004">figures 7a and 8a</figref> respectively represent a top view and perspective bottom view of lower plates,</li>
<li><figref idref="f0004">figures 7b and 8b</figref> respectively represent a perspective side view and a perspective top view of the lower plate of <figref idref="f0004">figures 7a and 8a</figref>, respectively, wherein prosthesis anchoring means are inserted according to two different embodiments,</li>
<li><figref idref="f0002">figure 9a</figref> represents a top view of another lower plate,</li>
<li><figref idref="f0002">figure 9b</figref> represents a sectional view of the lower plate along the plane plan C-C of <figref idref="f0002">figure 9a</figref>,</li>
<li><figref idref="f0004">figures 10a and 10b</figref> respectively represent a rear and side view of another upper plate.</li>
</ul></p>
<p id="p0007" num="0007">The intervertebral disk prosthesis according to the invention is constituted of an upper plate 1 which is articulated with respect to a lower plate 2 by means of a core 3, as can particularly be seen in <figref idref="f0002">figures 4a, 4b, 5a</figref> and <figref idref="f0003">6a</figref>. One advantage of the prosthesis according to the invention is that it comprises simple parts which can be designed so that the prosthesis is fitted on the cervical spine.</p>
<p id="p0008" num="0008">The upper plate 1, particularly visible in <figref idref="f0001">figures 1</figref> a and 1 b, is slightly concave on at least part 10 of its lower surface, so as to fit with the slightly convex upper surface of the core 3. The upper surface of the core 3 is complementary to the concave part 10 of the upper plate 1, enabling movement between the upper plate 1 and the core 3.</p>
<p id="p0009" num="0009">In an alternative embodiment, part of the upper surface of the upper<!-- EPO <DP n="4"> --> plate 1 is convex, as shown in <figref idref="f0004">figures 10a and 10b</figref>, in order to fit better onto<!-- EPO <DP n="5"> --> the vertebra whereon the prosthesis is to be fitted, the bottom of the vertebrae being concave. In this case, the convex part of the upper plate 1 is located in the front part of the upper plate, as can particularly be seen in <figref idref="f0004">figure 10b</figref>.</p>
<p id="p0010" num="0010">The lower plate 2 is substantially plane. In effect, its lower surface does not need to be convex or concave since the top of the vertebrae is substantially flat. In the embodiment of <figref idref="f0001">figures 2a, 2b</figref>, <figref idref="f0004">7a and 8a</figref>, the lower plate 2 comprises two pins 20 located opposite each other on two substantially parallel edges 21, 22 of the lower plate 2. Each pin 20 is curved towards the inside of the prosthesis and can thus enter recesses 30 located on the core 3. The core 3, particularly visible in <figref idref="f0001">figures 3a and 3b</figref>, comprises a substantially plane lower surface, provided to fit onto the lower plate 2. The core 3 is thin (for example 3 mm thick) for a cervical prosthesis or thicker (for example 15 mm) for a lumbar prosthesis.</p>
<p id="p0011" num="0011">In the embodiment of <figref idref="f0001">figures 3a, 3b</figref>, <figref idref="f0002">4a and 4b</figref>, the dimensions of each recess 30 of the core 3 are slightly greater than those of each pin 20 of the lower plate 2 so as to limit the clearance of the core 3 with respect to the lower plate 2, both in translation along an axis substantially parallel with the lower plate 2, and in rotation around an axis substantially perpendicular to the lower plate 2. The movement between the upper plate 1 and the core 3, as well as the clearance of the core 3 with respect to the lower plate 2, thus enable the patient to move and, if required, compensate for prosthesis positioning defects. This clearance also offers the advantage of preventing premature wear due to the stress applied to the prosthesis.</p>
<p id="p0012" num="0012">In the embodiment of <figref idref="f0002">figures 5a and 5b</figref>, the dimensions of each recess 30 of the core 3 are substantially the same as those of each pin 20 of the lower plate 2, so as to prevent any clearance of the core 3 with respect to the lower plate 2, both in translation and rotation. In the latter case, the only movement of the prosthesis authorised is that of the upper plate 1 with respect to the core 3.</p>
<p id="p0013" num="0013">In the embodiment in <figref idref="f0002">figures 9a and 9b</figref>, one of the pins 20 is replaced by a lug equipped with a drilling 200. A tag 23 fixes on the lug by means of a<!-- EPO <DP n="6"> --> dowel 24 entering the drilling 200. In an alternative embodiment, both pins are replaced by a lug whereon a tag 23 is fixed.</p>
<p id="p0014" num="0014">In the embodiment of <figref idref="f0003">figures 6a, 6b, 6c, 6d and 6e</figref>, the lower plate 2 does not comprise any pins 20 but two dowel pins 25 located in the vicinity of the centre of the lower plate 2. In this case, the core 3, by complementarity, does not comprise any recesses 30, but two wells 35 under its lower surface. The dimensions of the dowel pins 25 of the lower plate 2 and of the wells 35 of the core 3 are such that, in the alternative embodiment represented in <figref idref="f0003">figures 6b and 6c</figref>, a slight clearance in translation and rotation is permitted, and in the alternative embodiment represented in <figref idref="f0003">figures 6d and 6e</figref>, no clearance is permitted.</p>
<p id="p0015" num="0015">In another embodiment, not shown, the lower plate 2 comprises a rib on its upper surface and no pins 20 or dowel pins 25. The core 3, by complementarity, comprises a groove under its lower surface. The dimensions of the rib of the lower plate and the groove of the core are such that, in one alternative embodiment, a slight clearance in translation and rotation is permitted, and in another alternative embodiment, no clearance is permitted.</p>
<p id="p0016" num="0016">In another embodiment not shown, the lower plate 2 comprises, instead of the pins 20, two walls, arranged opposite each other, in the vicinity of two substantially parallel edges 21, 22 of the lower plate, but further in the prosthesis than the pins 20. The core 3 comprises complementary recesses with respect to the walls. The dimensions of each recess of the core in this embodiment are, either slightly greater, or substantially the same as those of each wall of the lower plate, so as to enable a slight clearance in translation and rotation or not.</p>
<p id="p0017" num="0017">In a further embodiment not shown, the female components are located on the lower plate and the male components on the core.</p>
<p id="p0018" num="0018">The intervertebral disk prosthesis according to the invention particularly makes it possible to correct lordosis defects and to add lordosis to the spine, for example the cervical spine. Therefore, the presence of an acute angle in the front-rear direction F, <figref idref="f0002">figure 4b</figref>, between the upper plate 1<!-- EPO <DP n="7"> --> and the lower plate 2 of the prosthesis is necessary. For example, this angle is between 0° and 15°. To adjust the angle required according to the patient, it is simply necessary to select a core 3 with a suitable angle between the mean plane representing its upper surface and the plane passing through its lower surface.</p>
<p id="p0019" num="0019">When the female components are located on the lower plates and the male components on the core, the lordotic core, in that it forms an acute angle in the front-rear direction, may then be integral with the plate by a projection entering a cavity or opening of the lower plate.</p>
<p id="p0020" num="0020">The inclination of the prostheses known in the prior art is obtained, either by the shape of the upper plate, when the core is flat, or by the position of the upper plate with respect to the core, when said core is convex. With respect to the first case of the prior art mentioned here, the machining of the prosthesis according to the present invention is more economical since the core is composed of a less expensive material (for example, polyethylene) than that composing the plates. With respect to the second case of the prior art mentioned here, the core of the present invention is not liable to be ejected outside the prosthesis since the angle between the plates is substantially constant when the prosthesis is in place.</p>
<p id="p0021" num="0021">If surgeons require a determined lordosis for one patient, they will select a core 3 allowing no clearance with respect to the lower plate 2. On the other hand, if they simply require the lordosis to remain within a range of values, they will select a core allowing a slight clearance in translation and rotation with respect to the lower plate 2.</p>
<p id="p0022" num="0022">The intervertebral disk prosthesis according to the invention may, in one alternative embodiment, represented in <figref idref="f0004">figures 7a, 7b, 8a and 8b</figref>, be anchored in the spinal column to prevent the prosthesis from migrating under the effect of the transversal resultant of the force exerted by the spinal column on the prosthesis in place, which increases with the lordosis. In this case, the lower plate 2 comprises one or more openings 28, 29 located in the vicinity of the rear side of the prosthesis, making it possible to receive anchoring means 4, 5.<!-- EPO <DP n="8"> --></p>
<p id="p0023" num="0023">In this way, in the case of <figref idref="f0004">figures 7a and 7b</figref>, the opening 28 of the lower plate 2 is rectangular and the anchoring means 4 is constituted of a body 40 and a head 41. The dimensions of the head 41 are slightly greater than those of the opening 28 of the lower plate 2, such that, once the anchoring means 4 are in place in a vertebra, the lower plate 2 is sandwiched between the head 41 of the anchoring means 4 and said vertebra. An angle, less than or equal to 90°, is comprised between the body 40 of the anchoring means 4 and the lower plate 2.</p>
<p id="p0024" num="0024">In the case of <figref idref="f0004">figures 8a and 8b</figref>, two circular openings 29 are comprised in the lower plate 2 and the anchoring means 5 are nail-shaped, with a head of greater dimensions than those of the openings 29 to make it possible to sandwich the lower plate 2 between the head of the anchoring means 5 and the vertebra whereon the prosthesis is anchored.</p>
<p id="p0025" num="0025">It should be clear to those skilled in art that the present invention is limited only by the scope of the appended claims.</p>
</description>
<claims id="claims01" lang="en"><!-- EPO <DP n="9"> -->
<claim id="c-en-01-0001" num="0001">
<claim-text>Intervertebral disk prosthesis comprising at least three parts including a first plate, referred to as the upper plate (1), a second plate, referred to as the lower plate (2), and a core (3), the upper surface of the core (3) being in contact with at least part (10) of the lower surface of the upper plate (1) and the lower surface of the core (3) being in contact with at least part of the upper surface of the lower plate (2), and the upper plate (1) being movable at least with respect to the core (3), the prosthesis further comprises cooperation means between the lower plate (2) and the core (3), so as to allow limited translation movements of the core (3) with respect to the lower plate (2) along an axis substantially parallel to the lower plate (2), and to allow limited rotation movements of the core (3) with respect to the lower plate (2), around an axis substantially perpendicular to the lower plate (2), <b>characterised in that</b> said cooperation means comprises :
<claim-text>- male means located opposite each other in the vicinity of edges of the lower plate (2) and formed by two pins, or one pin and one lug, or two lugs, or two walls cooperating with</claim-text>
<claim-text>- female means formed by two recesses (30) in edges of the core (3) and complementary to said pins, lugs or walls.</claim-text></claim-text></claim>
<claim id="c-en-01-0002" num="0002">
<claim-text>Intervertebral disk prosthesis according to any one of claim 1, <b>characterised in that</b> an angle imposed between the average planes passing through the plates is obtained <b>in that</b> the core (3) forms an acute angle in the front-rear direction (F).</claim-text></claim>
<claim id="c-en-01-0003" num="0003">
<claim-text>Intervertebral disk prosthesis according to claim 2, <b>characterised in that</b> the same plates (1, 2) can be assembled with cores (3) of different thicknesses.</claim-text></claim>
<claim id="c-en-01-0004" num="0004">
<claim-text>Intervertebral disk prosthesis according to any one of claims 2 or 3, <b>characterised in that</b> the angle between the upper (1) and lower (2) plates is between 0° and 15°.<!-- EPO <DP n="10"> --></claim-text></claim>
<claim id="c-en-01-0005" num="0005">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 4, <b>characterised in that</b> the core (3) is movable with respect to the upper (1) and/or lower (2) plates, which makes it possible to compensate for positioning defects of the three parts (1, 2, 3) of the prosthesis with respect to each other.</claim-text></claim>
<claim id="c-en-01-0006" num="0006">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 5, <b>characterised in that</b> at least part (10) of the lower surface of the upper plate (1) is concave and complementary to the upper convex surface (31) of the core (3).</claim-text></claim>
<claim id="c-en-01-0007" num="0007">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 6, <b>characterised in that</b> the dimensions of each male means are slightly less than those of each female means so as to enable a slight clearance between the core (3) and the lower plate (2).</claim-text></claim>
<claim id="c-en-01-0008" num="0008">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 7, <b>characterised in that</b> the dimensions of each male means are substantially the same as those of each female means so as to prevent any clearance between the core (3) and the lower plate (2).</claim-text></claim>
<claim id="c-en-01-0009" num="0009">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 8, <b>characterised in that</b> the male means of the lower plate (2) are two pins (20) curved towards the inside of the prosthesis and <b>in that</b> the female means of the core (3) are two recesses (30) at the level of the curved portion of said pins.</claim-text></claim>
<claim id="c-en-01-0010" num="0010">
<claim-text>Intervertebral disk prosthesis according to claim 9, <b>characterised in that</b> at least one of the pins (20) is replaced by a lug equipped with a drilling (200) whereon a tag (23) using a dowel (24) entering the drilling (200).</claim-text></claim>
<claim id="c-en-01-0011" num="0011">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 8, <b>characterised in that</b> the male means of the lower plate (2) are two walls located opposite each other in the vicinity of two edges (21, 22) of the prosthesis, and <b>in that</b> the female means of the core (3) are two recesses.<!-- EPO <DP n="11"> --></claim-text></claim>
<claim id="c-en-01-0012" num="0012">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 11, <b>characterised in that</b> the core (3) is made of polyethylene.</claim-text></claim>
<claim id="c-en-01-0013" num="0013">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 12, <b>characterised in that</b> the lower plate (2) comprises one or more openings (28, 29) in the vicinity of its front side, provided to receive prosthesis anchoring means (4, 5) in a vertebra.</claim-text></claim>
<claim id="c-en-01-0014" num="0014">
<claim-text>Intervertebral disk prosthesis according to claim 13, <b>characterised in that</b> the opening (28) of the lower plate (2) is rectangular, and <b>in that</b> the anchoring means (4) consist of a body (40), forming an acute angle with the lower plate (2), and a head (41).</claim-text></claim>
<claim id="c-en-01-0015" num="0015">
<claim-text>Intervertebral disk prosthesis according to claim 14, <b>characterised in that</b> the openings (29) of the lower plate (2) are circular, and <b>in that</b> the anchoring means (5) are nail-shaped.</claim-text></claim>
<claim id="c-en-01-0016" num="0016">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 15, <b>characterised in that</b> the upper plate (1) is convex on at least part of its upper surface to fit into the shape of the vertebrae.</claim-text></claim>
<claim id="c-en-01-0017" num="0017">
<claim-text>Intervertebral disk prosthesis according to any one of claims 1 to 16, <b>characterised in that</b> the dimensions of the core (3) are slightly lower than the dimensions of the lower plate (2), in a plane substantially parallel to the lower plate (2).</claim-text></claim>
<claim id="c-en-01-0018" num="0018">
<claim-text>Intervertebral disk prosthesis according to claims 6 and 17, <b>characterised in that</b> said dimensions of the core (3) with respect to those of the lower plate (2), in combination with the dimensions of both the height of the core (3), in a direction substantially perpendicular to the lower plate (2) and the radius of curvature of the convex surface of the core (3), enable that the upper (1) and lower (2) plates do not enter in contact even at a maximum inclination of the plates (1, 2).</claim-text></claim>
</claims>
<claims id="claims02" lang="de"><!-- EPO <DP n="12"> -->
<claim id="c-de-01-0001" num="0001">
<claim-text>Bandscheibenprothese aufweisend mindestens drei Teile, umfassend eine erste Platte, die als obere Platte (1) bezeichnet wird, eine zweite Platte, die als untere Platte (2) bezeichnet wird, und einem Kern (3), wobei die obere Oberfläche des Kerns (3) in Kontakt mit mindestens einem Teil (10) der Unterseite der oberen Platte (1) steht und die untere Oberfläche des Kerns (3) mit wenigstens einem Teil der Oberseite der unteren Platte (2) in Kontakt steht und die obere Platte (1) zumindest in Bezug auf den Kern (3) bewegbar ist, wobei die Prothese ferner eine Zusammenwirkungseinrichtung zwischen der unteren Platte (2) und dem Kern (3) aufweist,<br/>
um begrenzte Translationsbewegungen des Kerns (3) in Bezug auf die untere Platte (2) entlang einer Achse, die im Wesentlichen parallel zu der unteren Platte (2) ist, zu ermöglichen, und um begrenzte Drehbewegungen des Kerns (3) in Bezug auf die untere Platte (2) um eine Achse, die im Wesentlichen senkrecht zu der unteren Platte (2) ist zu ermöglichen,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Zusammenwirkungseinrichtung folgendes aufweist:
<claim-text>- Stecker, die einander gegenüberliegen in der Nähe von den Kanten der unteren Platte (2) angeordnet sind und durch zwei Stifte oder einen Stift und einer Öse oder zwei Ösen oder zwei Wände ausgebildet sind,</claim-text>
die zusammenwirken mit
<claim-text>- Aufnahmemitteln, die durch zwei Vertiefungen (30) in den Kanten des Kerns (3) ausgebildet und komplementär zu den Stiften, Ösen oder Wänden sind.</claim-text></claim-text></claim>
<claim id="c-de-01-0002" num="0002">
<claim-text>Bandscheibenprothese nach Anspruch 1,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
ein Winkel zwischen den mittleren Ebenen, welche durch die Platten verlaufen, dadurch erreicht wird, dass der Kern (3) einen spitzen Winkel in der Vorwärts- RückwärtsRichtung (F) bildet.</claim-text></claim>
<claim id="c-de-01-0003" num="0003">
<claim-text>Bandscheibenprothese nach Anspruch 2,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die gleichen Platten (1, 2) mit Kernen (3) verschiedener Dicke zusammengebaut werden können.<!-- EPO <DP n="13"> --></claim-text></claim>
<claim id="c-de-01-0004" num="0004">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 2 oder 3,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
der Winkel zwischen der oberen Platte (1) und der unteren Platte (2) zwischen 0° und 15° liegt.</claim-text></claim>
<claim id="c-de-01-0005" num="0005">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 4,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
der Kern (3) gegenüber den oberen Platten (1) und / oder unteren Platten (2) bewegbar ist, wodurch ein Positionierungsfehler der drei Teile (1, 2, 3) der Prothese zueinander kompensiert werden kann.</claim-text></claim>
<claim id="c-de-01-0006" num="0006">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 5,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
mindestens ein Teil (10) der unteren Oberfläche der oberen Platte (1) konkav und komplementär zur oberen konvexen Oberfläche (31) des Kerns ist (3).</claim-text></claim>
<claim id="c-de-01-0007" num="0007">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 6,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Abmessungen jedes Steckmittel geringfügig kleiner sind, als diejenigen der Aufnahmemittel, um einen leichten Zwischenraum zwischen dem Kern (3) und der unteren Platte zu ermöglichen (2).</claim-text></claim>
<claim id="c-de-01-0008" num="0008">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 7,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Abmessungen der Maße jedes Steckmittel im Wesentlichen die gleichen sind wie bei jedem Aufnahmemittel, um jeglichen Zwischenraum zwischen dem Kern (3) und der unteren Platte (2) zu verhindern.</claim-text></claim>
<claim id="c-de-01-0009" num="0009">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 8,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Steckmittel der unteren Platte (2) zwei zur Innenseite der Prothese gekrümmte Stifte (20) sind und dass die Aufnahmemittel des Kerns (3) zwei Aussparungen (30) auf Höhe des gekrümmten Teils der Stifte sind.</claim-text></claim>
<claim id="c-de-01-0010" num="0010">
<claim-text>Bandscheibenprothese nach Anspruch 9,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
wenigstens einer der Stifte (20) durch eine Öse ersetzt wird, welche mit einer Bohrung<!-- EPO <DP n="14"> --> (200) versehen ist, auf der eine Überlappung (23) mit Hilfe eines Dübels (24) der in die Öffnung der Bohrung (200) eintritt, angebracht ist.</claim-text></claim>
<claim id="c-de-01-0011" num="0011">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 8,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Steckmittel der unteren Platte (2) zwei einander gegenüberliegende Wandungen in der Nähe von zwei Kanten (21, 22) der Prothese sind, und dass die Aufnahmemittel des Kerns (3) zwei Aussparungen sind.</claim-text></claim>
<claim id="c-de-01-0012" num="0012">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 11,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
der Kern (3) aus Polyethylen hergestellt ist.</claim-text></claim>
<claim id="c-de-01-0013" num="0013">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 12,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die untere Platte (2) eine oder mehrere Öffnungen (28, 29) in der Nähe der Vorderseite aufweist, welche zur Aufnahme von Prothesenverankerungsträgern (4, 5) in einem Wirbel vorgesehen sind.</claim-text></claim>
<claim id="c-de-01-0014" num="0014">
<claim-text>Bandscheibenprothese nach Anspruch 13,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Öffnung (28) der unteren Platte (2) rechteckig ist und dass der Verankerungsträger (4) aus einem Körper (40), der einen spitzen Winkel mit der unteren Platte (2) bildet und einem Kopf (41) besteht.</claim-text></claim>
<claim id="c-de-01-0015" num="0015">
<claim-text>Bandscheibenprothese nach Anspruch 14,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Öffnungen (29) der unteren Platte (2) kreisförmig sind, und dass die Verankerungsträger (5) nagelförmig sind.</claim-text></claim>
<claim id="c-de-01-0016" num="0016">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 15,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die obere Platte (1) an wenigsten einem Teil ihrer Oberseite konvex ist, so dass sie in die Form der Wirbel passt.</claim-text></claim>
<claim id="c-de-01-0017" num="0017">
<claim-text>Bandscheibenprothese nach einem der Ansprüche 1 bis 16,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
<!-- EPO <DP n="15"> -->die Abmessungen des Kerns (3) geringfügig kleiner sind als die Abmessungen der unteren Platte (2) in einer Ebene, die im Wesentlichen parallel zur unteren Platte (2) ist.</claim-text></claim>
<claim id="c-de-01-0018" num="0018">
<claim-text>Bandscheibenprothese nach den Ansprüchen 6 und 17,<br/>
<b>dadurch gekennzeichnet, dass</b><br/>
die Abmessungen des Kerns (3) mit Bezug auf die der unteren Platte (2) in Kombination mit den Abmessungen beider Komponenten, sowohl der Höhe des Kerns (3), in einer im wesentlichen rechtwinkligen Richtung zur unteren Platte (2), als auch des Krümmungsradius der konvexen Oberfläche des Kerns (3), es ermöglichen, dass die obere Platte (1) und die untere Platte (2) selbst bei maximaler Neigung der Platten nicht miteinander in Berührung kommen.</claim-text></claim>
</claims>
<claims id="claims03" lang="fr"><!-- EPO <DP n="16"> -->
<claim id="c-fr-01-0001" num="0001">
<claim-text>Prothèse de disque intervertébral comprenant au moins trois pièces dont un premier plateau, dit plateau supérieur (1), un deuxième plateau, dit plateau inférieur (2), et un noyau (3), la surface supérieure du noyau (3) étant en contact avec au moins une partie (10) de la surface inférieure du plateau supérieur (1) et la surface inférieure du noyau (3) étant en contact avec au moins une partie de la surface supérieure du plateau inférieur (2), et le plateau supérieur (1) étant mobile au moins par rapport au noyau (3), la prothèse comprend en outre des moyens de coopération situés entre le plateau inférieur (2) et le noyau (3), de façon à limiter les mouvements en translation du noyau (3) par rapport au plateau inférieur (2) selon un axe sensiblement parallèle au plateau inférieur (2), et de façon à limiter les mouvements en rotation du noyau (3) par rapport au plateau inférieur (2), autour d'un axe sensiblement perpendiculaire au plateau inférieur (2), <b>caractérisé en ce que</b> lesdits moyens de coopération comprennent :
<claim-text>des moyens mâles disposés en vis-à-vis l'un de l'autre à proximité des bords du plateau inférieur (2) et formés par deux ergots, ou un ergot et un plot, ou deux plots ou deux parois</claim-text>
<claim-text>coopérant avec</claim-text>
<claim-text>des moyens femelles formés par deux évidements (30) dans les bords du noyau (3) et complémentaires par rapport auxdits ergots, plots ou parois.</claim-text></claim-text></claim>
<claim id="c-fr-01-0002" num="0002">
<claim-text>Prothèse de disque intervertébral selon la revendication 1, <b>caractérisée en ce que</b> l'on obtient un angle imposé entre les plans moyens passant par les plateaux, <b>en ce que</b> le noyau (3) forme un angle aigu dans le sens avant-arrière (F).</claim-text></claim>
<claim id="c-fr-01-0003" num="0003">
<claim-text>Prothèse de disque intervertébral selon la revendication 2, <b>caractérisée en ce que</b> les mêmes plateaux (1, 2) peuvent être assemblés avec des noyaux (3) de différentes épaisseurs.<!-- EPO <DP n="17"> --></claim-text></claim>
<claim id="c-fr-01-0004" num="0004">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 2 ou 3, <b>caractérisée en ce que</b> l'angle entre les plateaux supérieur (1) et inférieur (2) est compris entre 0° et 15°.</claim-text></claim>
<claim id="c-fr-01-0005" num="0005">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 4, <b>caractérisée en ce que</b> le noyau (3) est mobile par rapport aux plateaux supérieur (1) et/ou inférieur (2), ce qui permet de rattraper les défauts de positionnement des trois pièces (1, 2, 3) de la prothèse les unes par rapport aux autres.</claim-text></claim>
<claim id="c-fr-01-0006" num="0006">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 5, <b>caractérisée en ce qu'</b>au moins une partie (10) de la surface inférieure du plateau supérieur (1) est concave et complémentaire de la surface convexe supérieure (31) du noyau (3).</claim-text></claim>
<claim id="c-fr-01-0007" num="0007">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 6, <b>caractérisée en ce que</b> les dimensions de chaque moyen mâle sont légèrement inférieures à celles de chaque moyen femelle de façon à permettre un léger débattement entre le noyau (3) et le plateau inférieur (2).</claim-text></claim>
<claim id="c-fr-01-0008" num="0008">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 7, <b>caractérisée en ce que</b> les dimensions de chaque moyen mâle sont sensiblement identiques à celles de chaque moyen femelle afin d'empêcher tout débattement entre le noyau (3) et le plateau inférieur (2).</claim-text></claim>
<claim id="c-fr-01-0009" num="0009">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 8, <b>caractérisée en ce que</b> les moyens mâles du plateau inférieur (2) sont deux ergots (20) recourbés vers l'intérieur de la prothèse et <b>en ce que</b> les moyens femelles du noyau (3) sont deux évidements (30) au niveau de la partie recourbée desdits ergots.<!-- EPO <DP n="18"> --></claim-text></claim>
<claim id="c-fr-01-0010" num="0010">
<claim-text>Prothèse de disque intervertébral selon la revendication 9, <b>caractérisée en ce qu'</b>au moins l'un des ergots (20) est remplacé par un plot muni d'un perçage (200) sur lequel est fixée une patte (23) à l'aide d'une goupille (24) pénétrant dans le perçage (200).</claim-text></claim>
<claim id="c-fr-01-0011" num="0011">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 8, <b>caractérisée en ce que</b> les moyens mâles du plateau inférieur (2) sont deux parois positionnées en vis-à-vis l'une de l'autre à proximité des deux bords (21, 22) de la prothèse, et <b>en ce que</b> les moyens femelles du noyau (3) sont deux évidements.</claim-text></claim>
<claim id="c-fr-01-0012" num="0012">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 11, <b>caractérisée en ce que</b> le noyau (3) est en polyéthylène.</claim-text></claim>
<claim id="c-fr-01-0013" num="0013">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 12, <b>caractérisée en ce que</b> le plateau inférieur (2) comprend une ou plusieurs ouvertures (28, 29) à proximité de son côté antérieur, prévues pour recevoir des moyens d'ancrage (4, 5) de la prothèse dans une vertèbre.</claim-text></claim>
<claim id="c-fr-01-0014" num="0014">
<claim-text>Prothèse de disque intervertébral selon la revendication 13, <b>caractérisée en ce que</b> l'ouverture (28) du plateau inférieur (2) est rectangulaire, et <b>en ce que</b> le moyen d'ancrage (4) est constitué d'un corps (40), faisant avec le plateau inférieur (2) un angle aigu, et d'une tête (41).</claim-text></claim>
<claim id="c-fr-01-0015" num="0015">
<claim-text>Prothèse de disque intervertébral selon la revendication 14, <b>caractérisée en ce que</b> les ouvertures (29) du plateau inférieur (2) sont circulaires, et <b>en ce que</b> les moyens d'ancrage (5) ont la forme d'un clou.<!-- EPO <DP n="19"> --></claim-text></claim>
<claim id="c-fr-01-0016" num="0016">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 15, <b>caractérisée en ce que</b> le plateau supérieur (1) est bombé sur au moins une partie de sa surface supérieure pour s'adapter à la forme des vertèbres.</claim-text></claim>
<claim id="c-fr-01-0017" num="0017">
<claim-text>Prothèse de disque intervertébral selon l'une quelconque des revendications 1 à 16, <b>caractérisée en ce que</b> les dimensions du noyau (3) sont légèrement inférieures aux dimensions du plateau inférieur (2), dans un plan sensiblement parallèle au plateau inférieur (2).</claim-text></claim>
<claim id="c-fr-01-0018" num="0018">
<claim-text>Prothèse de disque intervertébral selon les revendications 6 et 17, <b>caractérisée en ce que</b> lesdites dimensions du noyau (3) par rapport à celles du plateau inférieur (2), en combinaison avec les dimensions à la fois de la hauteur du noyau (3), dans une direction sensiblement perpendiculaire au plateau inférieur (2) et du rayon de courbure de la surface convexe du noyau (3), permettent que les plateaux supérieur (1) et inférieur (2) ne soient pas en contact, même à une inclinaison maximum des plateaux (1, 2).</claim-text></claim>
</claims>
<drawings id="draw" lang="en"><!-- EPO <DP n="20"> -->
<figure id="f0001" num="1a,1b,2a,2b,3a,3b"><img id="if0001" file="imgf0001.tif" wi="153" he="232" img-content="drawing" img-format="tif"/></figure><!-- EPO <DP n="21"> -->
<figure id="f0002" num="4a,4b,5a,5b,9a,9b"><img id="if0002" file="imgf0002.tif" wi="151" he="233" img-content="drawing" img-format="tif"/></figure><!-- EPO <DP n="22"> -->
<figure id="f0003" num="6a,6b,6c,6d,6e"><img id="if0003" file="imgf0003.tif" wi="160" he="225" img-content="drawing" img-format="tif"/></figure><!-- EPO <DP n="23"> -->
<figure id="f0004" num="7a,7b,8a,8b,10a,10b"><img id="if0004" file="imgf0004.tif" wi="145" he="219" img-content="drawing" img-format="tif"/></figure>
</drawings>
<ep-reference-list id="ref-list">
<heading id="ref-h0001"><b>REFERENCES CITED IN THE DESCRIPTION</b></heading>
<p id="ref-p0001" num=""><i>This list of references cited by the applicant is for the reader's convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.</i></p>
<heading id="ref-h0002"><b>Patent documents cited in the description</b></heading>
<p id="ref-p0002" num="">
<ul id="ref-ul0001" list-style="bullet">
<li><patcit id="ref-pcit0001" dnum="US6368350B1"><document-id><country>US</country><doc-number>6368350</doc-number><kind>B1</kind></document-id></patcit><crossref idref="pcit0001">[0003]</crossref></li>
</ul></p>
</ep-reference-list>
</ep-patent-document>
